prevalence of urinary tract infections (uti) sexually - Zoo-unn.org

Animal Research International (2008) 5(2): 876 – 879 876PREVALENCE OF URINARY TRACT INFECTIONS (UTI) IN SEXUALLYACTIVE WOMEN OF ABAKALIKI, EBONYI STATE, NIGERIAANI, Ogonna Christiana and MGBECHI, Edna KelechukwuDepartment of Applied Biology, Ebonyi State University, Abakaliki, Ebonyi State, NigeriaCorresponding Author: Ani, O. C. Applied Biology Department, Ebonyi State University, Abakaliki, EbonyiState, Nigeria. Phone +234 8076688913ABSTRACTA research to investigate the prevalence of urinary tract infections in sexually active women (18 –41 years) from selected health care centres in Abakaliki was carried out. Attempt was made tofined out the number of treated cases, aetiologic agents and age range with highest incidence o furinary tract infections over the study period (2004 – 2005). Medical records of urinary tractinfected women from the selected health care centres were reviewed. The prevalence of urinarytract infections was high (1232) among the study group and Escherichia coli was implicated as theprincipal causative agent of these infections. The high prevalence recorded in this study makes itnecessary for women to be adequately educated on matters affecting their reproductive health.There is also the need for government of the state to provide improved, adequate and affordablehealth care services in the communities.Keyword: Prevalence, Urinary, Tract infection, Sexually active womenINTRODUCTIONUrinary tract infection (UTI) is the infection of anypart of the urinary tract. The urinary tract consists ofthe kidneys, ureters, bladder and urethra. Any part ofthese structures can become infected but bladder andurethra infections are the most common (Anon,2006). The bladder infection is known as cystitiswhile that of the urethra is known as pyelonephritisand is more serious.The two types of UTI are lower UTI which isan infection of the lower part of the urinary tract (thebladder and urethra) and upper UTI which is aninfection of the upper part of the urinary tract(kidneys and ureters). The upper UTI is potentiallymore serious than the lower one because there is apossibility of kidney damage.Most UTIs are caused by bacteria that canlive in the digestive tract, the vagina or around theurethra. Infection occurs when bacteria enter thenormally sterile urinary system and multiply there.They produce enzymes which help them feed ontissues of the host and thus damage them (AdultHelath Advisor, 2005).Bacteria can enter the urinary systemthrough the urethra or more rarely through the bloodstream (Macnair, 2006). Poor toilet habits, pregnancyin women and prostate enlargement in men canpredispose one to infection. The aetiologic andclinical presentation of UTI is similar in bothindustrialized and developing nations but the range ofinfections varies form place to place (Latif, 2004).Women are more prone to UTIs than males.According to Macnair (2006), about 11 % ofgirls and 4% of boys have UTI before they reach theage of 16. About 40 – 50 % of women and 12 % ofmen have UTI at some time of their lives. It isbelieved that sexual activity may be responsible forhigh infection rate in sexually active women as theproblem begins once the women become sexuallyactive. Mercola (2001) also reported that as many as60 % of women contact UTI at some point in theirlive and that at least a third of the women with UTIwill experience a recurrent infection during thefollowing year. UTIs are most common in sexuallyactive women and increase in people living withdiabetes. A common cause of UTI is an increase insexual activity such as vigorous sexual intercoursewith a new partner. This leads to what is known ashoneymoon cystitis. Women are more prone to UTIthan males because their urethra is much shorter andcloser to the anus than in males. Hence bacteria fromthe anus can pass easily into the urinary tract.Females also have three openings in a very smallarea (the rectum, the vagina and the meatus of theurethra). Women also lack the bacteriostaticproperties of prostatic secretions that are present inmales. They are also susceptible to recurrent UTIsbecause they do not secrete a certain blood groupantigens (Thompson, 2006).Some common symptoms of UTI arefrequent urinations, frequent urge to urinate,pain/burning sensation in urethra when urinating,discomfort at lower abdomen, soreness in the lowerabdomen and back. When the infection is welldeveloped and had spread up to the kidney anduterus, back pains, chills, fever, nausea and vomitingmay be experienced (Janice, 2006). The infection canbe diagnosed by testing clean urine sample for whiteblood cells and other components. Urine may also becultured to allow the growth of any bacteria andsubsequent identification. Traditional treatment iswith the use of antibiotics.This research was carried out in order tofind out the real situation of urinary tract infectionsamong sexually active women in Abakaliki with theaim of determining the number of recorded cases innotable hospitals and private diagnostic laboratoriesISSN: 159 – 3115 ARI 2008 5(2): 876 – 879www.zoo-unn.org

Ani and Mgbechi 877in the town, the aetiologic agents among sexuallyactive women and the age class or age with thehighest incidence.MATERIALS AND METHODSStudy Area: Abakaliki is the capital of Ebonyi Statein the South – eastern part of Nigeria. It is denselypopulated and relatively developed with such basicamenities as pipe borne water, electricity, transportand communication services. The populace is madeup of farmers, civil servants, businessmen andwomen, students and politicians. Notable hospitalsthat serve most populace within and around the townare Ebonyi State University Teaching Hospital(EBSUTH), Federal Medical Centre (FMC), Generaland private hospitals. Private diagnostic laboratoriessuch as St. Luke’s and Anchor – C render good healthservices to the populace.Study Population: The study population includeswomen between 18 and 41 years within the studyarea. The study period of two years was undertakento provide sufficient data for meaningful analysis andminimize confounding variables that may arise due tochanging practices over time.Data Collection: The study involved the review ofmedical records of the study population using theiradmission and discharge registers, clinic andlaboratory records with the consent of laboratoryscientists and nurses on duty. Such records containedthe rate of infection, the ages of women infected andcausal organisms implicated.Data Analysis: The results of the research wereanalyzed using Measures of Central Tendencies tofind the age/age class that had highest infection(modal age).RESULTSA total number of 1232 cases were treated over theyears and the year 2005 had a higher prevalence of696 (56%) (Table 1). Among the hospitals andlaboratories, Federal Medical Centre recorded thehighest prevalence of 552 (44.8 %) while EbonyiState University Teaching Hospital recorded the leastprevalence of 143(12.4 %) (Table 1). The modalclass was 18 – 23 which recorded 38 % of the UTIcases and the modal age was 22 years. This wasfollowed by age class 24 – 29 which had 20.2 %. 30– 35 that had 18.8 % and the age class 36 – 41 yearshad the least (12.1 %) (Table 2). Cumulatively,January – March period had the highest number ofcases (396) followed by April – June (335), October –December (269) while July – September quarter hadthe least (132) (Figure 1). The order of prevalencerate of causal organisms of UTI was E. coli (67.2 %)> Pseudomonas spp (12.1 %) > Staphylococcusaureus (1.2 %) Klebsiella spp (3.7 %) > Schistosomahaematobium (2.9 %) > Amoeba spp (2.1 %)>Streptococcus faecalis (0.5 %) > Blastomyces spp(0.3 %) (Figure 2).Table 1: Prevalence of UTI among differenthospitals/establishments from Jan 2004 –December 2005 in Abakaliki, Ebonyi StateHospitals/establishmentcasesin2004casesin2005Totalcases%casesFederalMedicalCentre (FMC) 207 345 552 44.8Ebonyi StateUniversityTeachHospital 67 76 143 12.0St. Luke’sPrivatediagnosticlaboratory 91 144 235 19.1Anchor – C.PrivatediagnosticLaboratory 171 131 302 24.4Total 533(43%)696(56%)1232Table 2: Prevalence of UTI by age amongsexually active Women in Abakaliki, EbonyiStateAge class Year Year Total case Prevalence2004 2005 of infection18 – 23 226 253 479 38.924 – 29 166 206 372 30.230 – 35 76 155 231 18.836 – 41 68 82 150 12.1Total 596 696 1232 100Number of UTI Cases300250200150100500239157Jan-March133202April-June2004200565167 170July-SeptQuarterly Distribution99Oct-DecFigure 1: Quarterly Prevalence of UTIAmong Sexually Active Women inAbakaliki, Ebonyi State

Prevalence of urinary tract infections in sexually active women 87812.11.23.72.92.1 0.5 0.3E. ColiPseudomonas sppStaphylococcus aureusKlebsiella sppSchistosoma heamatobiumAmoeba sppStreptococcus faecalisBlastomyces spp67.2Figure 2: Casual organisms implicated by laboratory findingsDISCUSSIONOne thousand two hundred and thirty – two urinarytract infection cases were treated in the study area intwo years under review.The prevalence of this infection in this studywas quite high and this agrees with the report ofChevins (2001) that this infection was a commonmedical complaint among women in their sexuallyactive years. The age class 18 – 23 had the highestprevent rate of 38.9 %. At this age range,women/girls tend to live active sexual life andpromiscuity is sometimes on the increase. This alsoagreed with APUA (2003) that women at the peak oftheir sexual active years had high prevalence ofurinary tract infection. Women at this age range alsofeel ashamed of going for medical check – ups andtherefore indulge in one form of self medication orthe other or even prefer to die in silence (Ehinmidu,2003).The year 2005 had a higher rate of infection(56.5 %) than 2004. This could be attributed to thefact that literacy level and health awareness of thepopulace/masses keep improving year after year. Asthis happens, more women get aware of their healthneeds, become bolder to face their problems andhence pay more visits to the hospitals and privatelaboratories for accurate diagnosis and treatmentmore than the preceding years.The overall prevalence of UTIs in the yearsunder review was highest in the January – Marchquarter (396). The major occupation of the people ofthe study area is farming and October – Decemberquarter is a time of harvest. The farmers thereforetend to concentrate on harvesting and selling of theirproducts neglecting their health needs. By the firstquarter of the year when such activities may havelessened, they then think of taking care of theirhealth needs. This was in consonance with Latif(2004) that people in developing countries oftenpresent themselves for care with more severe illnessand often after complications have developed.The order of prevalence of causal organisms in thisstudy (E. coli> Pseudomonas spp > Staphylococcusaureus etc) contrasted the report of Ehinmidu (2003)of (Pseudomonas aeruginosa > Staphylococcusaureus > E. coli) although the same organisms wereidentified. The result, however agreed with Chevins(2001), Jawetz and Adelberg (2001) and Nyberg et al(2004) that E. coli was the primary causal agent ofmost urinary tract infections.From the findings of this research, it wasevident that urinary tract infection was prevalent insexually active women. On the basis of this therefore,there is need for improved, adequate and affordablehealth care services in the communities especially inmatters of reproductive health. Promiscuity and girl –child marriage should be discouraged while massesshould be educated on the importance of personalhygiene in order to help them elevate their healthstatus and manage themselves properly.REFERENCESANON, (2006). Urinary tract infection in women.http://familydoctor.org/online/famdocen/home/women/gen-health/190/html.ADULT HEALTH ADVISOR (2005). Bacterial in Urine,do symptoms. (http://www.med.umich.ed./llibr/aha/ahaasybaccris.htm)APUA (2003). UTI treatment at a turning point,improving antimicrobial prescribing foruncomplicated UTIs in an era of increasingantibiotic resistance. An Alliance for thePrudent Use of Antibiotics (APUA)Roundtable Publication, MA.CHEVINS, C. (2001). UTIs in Women. 1 st Edition,Nidus Information services Inc. New York.EHINMIDU, J. O. (2003). Antibiotic susceptibilitypatterns of urine bacterial isolates in Zaria,Nigeria. Tropical Journal o f PharmaceuticalResearch, 2(2): 223 – 238.JANICE, K. (2006). Urinary tract infection – causesand prevention: the natural way.http://www.janicehealth.com/uti.htm.

Ani and Mgbechi 879JAWETZ, M. and ADELBERG, S. (2001). MedicalMicrobiology. 22 nd Edition McGraw HillCompanies, Inc. USA.LATIF, A. S. (2004). Urogental infections in thetropics. Pages 60 – 65. In: LATIF, A. S andSPINGS, A. (Eds). STI/HIV project. TheAustralasian College of Tropical MedicinePublishing Press, Harare.MACNAIR, I. (2006). Urinary Tract infectionhttp://www.bbc.co.uk/health/conditions/urinarytract2.shtml.MERCOLA, J. (2001). Cranberry juice for urinary tractinfections. British Medical Journal, 322: 1571– 1573.NYBERG, L., BRIGGS, J. and KRANZFELDER, K.(2004). The UTIs. A review. NationalWomen’s Health information Centre,Department of health and human services ofUnited States of America.THOMPSON, T. (2006). Urinary Tract InfectionMedication: Antibiotics for UTI.http://www.nativeemedies.com/articles/urinary-tract-infection-medication-antibioticsuti.html.